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The deaths caused by influenza which occurred around the time of World War I wiped out 20-million people worldwide; a death count which far exceeded the actual loss of life due to the war itself. Today, the disease of Influenza (or, “the flu”) has become much more treatable and therefore far less dangerous. However dangers still exist in that the flu has become so commonplace, when an individual begins to feel the all too familiar symptoms of headache, aches and pains, chills and a fever, it is naturally assumed that influenza is the cause. The fact is, however, that the apex of the flu season is only one to three months long, and many times it is a different virus or bacteria that is causing the symptoms. There have been recent reports of people dying of bacterial infections that were left untreated because they and their doctors thought they had influenza and used the new anti-flu drugs instead of checking to see if antibacterial antibiotics were needed. For this reason, it is important that proper diagnostic techniques are applied whenever possible.
There are only three types of true influenza virus: A, B, and C, and the C type is relatively rare. The A type can be separated into strains derived from two antigens, the H and the N. About once a year, a slight modification (called a “drift”), occurs in either one or both antigens, however that change is sufficient to cause individuals who had the last “popular” strain to be vulnerable to the most recent one. Massive changes (called “shifts)” in the antigen of the A virus occur approximately once every decade, resulting in widespread epidemics of the flu due to the major portion of the population’s lack of immunity to the shifted virus. The yearly drifts can also result in strains that large numbers of people are susceptible to, but this process can take several years.
When an individual becomes infected with a new viral strain, his immune system must “start fresh” in order to successfully combat this infection. The response is therefore relatively slow; it often takes several days to accumulate an effective defense, and by this time, the individual may already be seriously ill. For the elderly especially, the results can be fatal. In fact, according to The American Cancer Society, in excess of 90% of people who die each year of influenza are over the age of 65. For this reason, presumptive treatment in the elderly is necessary, even when the classic influenza symptoms are not present.
Every year, the US Center for Disease Control and Prevention, along with those companies which manufacture the vaccines, establish which strains are most apt to create flu epidemics for the following year, and subsequently develop vaccines that are “custom-made” for those particular strains. Today, “the flu shot” is a respected form of preventative treatment, however in the sixties and seventies, it developed an unsavory reputation because scientists were not yet adept at predicting which strains of flu were likely to crop up in the coming year.
Generally, the flu vaccine is given as a single dose, and it usually takes about a month or so after the vaccine is administered for an individual to develop total immunity.
Two new anti-flu medicines were just recently approved by the Food and Drug Administration; one an inhalant, the other a pill. Both of these drugs can help lessen the effects of all three influenza viruses by blocking neuramidase, an enzyme that the flu viruses use to attach themselves to the cells they are preparing to infect. Regrettably, these new treatments are not approved for use in children and they are only effective on influenza; They do nothing to combat bacterial infections. Thus the FDA strongly suggests that patients and doctors use these new anti-flu drugs with caution and look out for other potential causes of flu-like symptoms.
Approximately 50 million Americans are stricken with the flu virus every year. Even the healthiest adults generally require a weeklong recovery period, which is not merely aggravating, it’s expensive. The Flu is reported to cost over $5 billion in lost work and hospital bills every season. For these reasons, swift diagnosis of influenza is extremely important. After all, an accurate diagnosis is necessary to apply appropriate treatments, because most treatments are more successful when they are administered within the first two days of virus’ attack. In addition, rapid and accurate diagnosis would help to present an early picture of local influenza activity and possibly reduce the improper prescribing of antibacterial drugs.